Egg quality: potential for optimization?

    • New

    Good afternoon,

    I would like to briefly describe our case:
    Brief profile

    • Woman 34 yrs: Tubal occlusion, AMH 7.9 (without PCOS pattern), mild endometriosis, hyperthyroidism, hypertension (both controlled by medication).
    • Male 33 years: spermiogram unremarkable.

    Attempt 1 (IVF)

    • Stimulation: antagonist protocol with Rekovelle and Ganirelix; triggered with Ovitrelle
    • Puncture at ZT 13: 13 eggs, all mature
    • Fertilization: IVF, poor fertilization rate (1/13, possibly 2 "trailed" but not further developed)
    • Laboratory findings: granularity / "fingerprint" pattern of the egg cells
    • Transfer: Day 3 transfer (single 8-cell)
    • Result: negative


    Experiment 2 (IVF/ICSI)

    • Stimulation: same antagonist protocol with recovelle (minimally increased in the course) and Ganirelix; triggered with Ovitrelle
    • Puncture at ZT15: 10 oocytes, of which 9 mature + 1 slightly degenerated
    • Fertilization: 6 fertilized eggs
      • ICSI: 5/7 fertilized
      • IVF: 1/3 fertilized
    • Laboratory: no granularity, oocytes morphologically better, but poor blastogenesis (2 blastocysts with C grading)
    • Double transfer on day 5
    • Result: negative


    What options do we have to improve the results and have a child with our own eggs?
    When should we switch to egg donation?

    Thank you very much in advance!

    • New

    Hello Lisas.reise, welcome to the forum. Google pimp my eggs. It's a compilation of supplements designed to improve egg quality. We did the equivalent for pimp my sperm as we had an egg donation and it significantly improved the spermiogram. So why shouldn't it also work with eggs?

    Regarding PCOS: Have they ever tested whether you have insulin resistance? Sometimes metformin is given if you want to have children, even if you don't (yet) have diabetes. Good luck.

    BJ 1982, AMH 2020: 0,2. Partner: OAT Syndrom.

    1xIUI 08/20 neg. 1x TF nach ICSI 11/20 neg. Danach nur noch Nullbefruchtung und zweimal Nullpunktion.

    08/21 Erstvisite KIWU in Madrid.

    Transfer einer wunderschönen 6AA Blasto am 25.3.22

    Urintest 3.4. Positiv

    BT 5.4. : HCG 570 :love:

    US 22.04. Das Herzchen schlägt <3

    Es wird ein Mädchen :smiling_face_with_hearts:

    Dezember 2022 Geburt unserer wundervollen süßen Tochter :smiling_face_with_hearts::heart_with_ribbon:

    • New

    strawberry & Conby Thanks for your feedback and tips 😊
    To your questions:
    The tubes are fused and there is no hydrosalpinx (fluid in the fallopian tube).
    I do not meet the diagnostic criteria for PCOS. I only have the high AMH value and no irregular cycles and no hyperandrogenemia.
    The HOMA index to rule out insulin resistance has not yet been checked. However, I have pressed for it several times and have an appointment for a blood test soon.
    I am already unconsciously pimping my eggs and supplementing a good multi-preparation with omega 3, vitamin D & quite a lot of Q10

    Are there any medical options (e.g. by adjusting the stimulation protocol or similar) that could still have a positive influence on egg quality?

    • New
    Quote from Nes

    Dear Conby, sorry to butt in for a moment 😊. Would you be so kind as to tell me exactly which preparation you have chosen regarding "pimp my sperm"? The market is really confusing. Thank you!

    Hey, unfortunately I don't remember, it was 4 years ago. But I followed the emo recommendation here https://www.wegweiser-kinderwunsch.de/spermien-verbessern/

    And looked at what was in stock at the big A. We also had the recommendation from the Spanish clinic to take turmeric. But you have to know that it is a strong antioxidant and should therefore be taken independently of other supplements if possible so that no active ingredients are absorbed. Good luck!

    BJ 1982, AMH 2020: 0,2. Partner: OAT Syndrom.

    1xIUI 08/20 neg. 1x TF nach ICSI 11/20 neg. Danach nur noch Nullbefruchtung und zweimal Nullpunktion.

    08/21 Erstvisite KIWU in Madrid.

    Transfer einer wunderschönen 6AA Blasto am 25.3.22

    Urintest 3.4. Positiv

    BT 5.4. : HCG 570 :love:

    US 22.04. Das Herzchen schlägt <3

    Es wird ein Mädchen :smiling_face_with_hearts:

    Dezember 2022 Geburt unserer wundervollen süßen Tochter :smiling_face_with_hearts::heart_with_ribbon:

    • New

    Dear Lisas.reise,

    Thank you very much for your question and please excuse me for not replying until today: the Christmas vacations ended yesterday in Spain, which has caused the monitoring of this forum to come to a bit of a standstill.

    Let's assume that both karyotypes have been tested and found to be normal (if this test has not yet been done, this would be the first step to check this).

    If both are normal, it would be interesting to examine the sperm fragmentation to rule out a sperm factor, even if the sperm analysis is normal.

    Improving egg quality is a tricky question as there is no specific recommended treatment that ensures significant improvement. It also needs to be individualized. Many patients prepare their bodies (not just their eggs) with methods such as "Pimp My Eggs", with the help of a nutritionist specializing in fertility, or with acupuncture, etc. Every woman is different and needs a customized solution. For this reason, we at Vida Fertility have a large network of cooperation partners to whom we refer our patients if necessary. As far as we and our treatment are concerned, there are options such as antral follicle preparation, where patients take oral oestrogen before stimulation. Of course, ICSI (and not conventional IVF) should be performed.

    Regarding your question about when to switch from IVF to egg donation: We recommend egg donation when we feel that the chances of pregnancy with the patient's own eggs are very low and they feel that they have tried everything they can with their own gametes. This is a very open conversation that we have with them and there is no specific time or value in deciding when to go for egg donation. This is a very personal matter and depends on each patient individually.

    Yours sincerely,
    Dr. Estefanía Rodríguez

    Ihr Vida Fertility Team <3

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